Provider Demographics
NPI:1063540318
Name:GUTTERSON, STEVEN GEOFFREY (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GEOFFREY
Last Name:GUTTERSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 W NECK RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2619
Mailing Address - Country:US
Mailing Address - Phone:516-938-0015
Mailing Address - Fax:
Practice Address - Street 1:14 W NECK RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2619
Practice Address - Country:US
Practice Address - Phone:516-938-0015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0438581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice